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Paediatric developmental venous anomalies (DVAs): how often do they bleed and where?
Adikarige H D Silva1, Haren Wijesinghe1, William B Lo1
1Department of Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
Summary
Developmental venous anomalies (DVAs) in children are often asymptomatic but carry a higher risk of intracranial hemorrhage than in adults. Cerebellar location and co-occurring cavernous malformations increase this risk.
Area of Science:
- Neurology
- Pediatric Radiology
- Vascular Malformations
Background:
- Developmental venous anomalies (DVAs) are common, low-flow vascular malformations.
- Data on the natural history and hemorrhage risk of pediatric DVAs are limited.
Purpose of the Study:
- To evaluate the clinical and radiological features of pediatric DVAs.
- To identify risk factors and outcomes associated with intracranial hemorrhage in children with DVAs.
Main Methods:
- Retrospective review of 303 radiological studies from 2004-2014.
- Analysis of clinical records, imaging, and databases for 52 pediatric patients with DVAs.
Main Results:
- Most pediatric DVAs (92.3%) were incidental findings.
- Frontal lobe (42.3%) was the most common location; 5.8% had associated cavernous malformations.
- Hemorrhage occurred in 7.7% of pediatric patients, with increased risk in cerebellar DVAs and those with cavernous malformations.
Conclusions:
- Pediatric DVAs have a higher hemorrhage risk than adult DVAs, particularly when located in the cerebellum or associated with cavernous malformations.
- No hemorrhages were observed during the 3.8-year median follow-up period in this cohort.
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